Provider Demographics
NPI:1659573616
Name:ADHIKARI, MALA MATTI (MD)
Entity Type:Individual
Prefix:DR
First Name:MALA
Middle Name:MATTI
Last Name:ADHIKARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 LAWRENCE EXPY
Mailing Address - Street 2:SUIT 204
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-5173
Mailing Address - Country:US
Mailing Address - Phone:408-851-6100
Mailing Address - Fax:
Practice Address - Street 1:20990 VALLEY GREEN DR APT 624
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-1834
Practice Address - Country:US
Practice Address - Phone:408-517-0499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85127174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist